Sustainer Contribution Form
September 11, 2012
News from Cornwall and Cornwall-on-Hudson
www.cornwall-ny.com/www.cornwall-on-hudson.com
Sustainer Contribution Form
(please print and mail the completed form with your contribution)
Yes, I want to make a contribution to keep an independent online source for news in the greater Cornwall, N.Y. area.
Name __________________________________
Address ________________________________
________________________________
Telephone ______________________________
I would like my name included in an online list of donors. Yes No (circle one)
I would like to contribute the following:
___ $1,000
___ $ 500
___ $ 250
___ $ 100
___ Other (Amount:_________)
Please make your check payable to: Cornwall Media, LLC and mail it to News from Cornwall and Cornwall-on-Hudson c/o Cornwall Media, LLC, P.O. Box 54, Cornwall-on-Hudson, N.Y. 12520. If you have any questions or ideas about the community website email me at [email protected].
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